CCIIO Proposed 2017 Benchmark EHB Plans

The Patient Protection and Affordable Care Act requires “nongrandfathered” health plans in the individual and small group markets to cover Essential Health Benefits (EHBs) in ten benefit categories (see Pub. L. 111-148, Title I, Subtitle D, Part I, § 1302; codified at 42 USC 18022).  The U.S. Centers for Medicare & Medicaid Services (CMS) Center for Consumer Information and Insurance Oversight (CCIIO) recently posted a list of proposed EHB plans to be used as benchmarks for EHBs that all states and the District of Columbia must cover in 2017.  The 2017 EHB benchmark plans are plans that were sold in 2014, and may not totally comply with current federal requirements.  States may select a 2017 EHB benchmark plan to serve as a reference for further development.  For each proposed 2017 EHB plan, the CCIIO also provides: “(1) a summary of the plan’s coverage of certain benefits that appear on the Plans & Benefits Template, including a list of covered prescription drug categories and classes; and (2) supporting plan documents that provide detail regarding all plan coverage, limits, and exclusions.”  The CCIIO is accepting public comment on the 2017 EHB benchmark plans until 11:59pm EDT, September 30, 2015.  For additional information, see the CCIIO Information on Essential Health Benefits Benchmark Plans page.